Intermittent explosive disorder — a controversial mental illness marked by outbursts of uncontrollable rage — is so common among adolescents it affects one in 12 teens, a large new study finds.

Harvard Medical School researchers, in a study based on in-person interviews with more than 10,000 adolescents ages 13 to 17, found that about 8% met the criteria for intermittent explosive disorder, or IED.

The findings suggest the disorder is affecting hundreds of thousands of youths — close to six million in the U.S. alone, according to a statement released with the study.

But observers worry it could trigger a “manufactured epidemic” among teens and lead to extreme but predictable teenage behaviour being labelled as symptoms of a mental illness requiring treatment — including mood-altering drugs.

According to the Diagnostic and Statistical Manual of Mental Disorders — psychiatry’s official catalogue of mental illness, now undergoing its first major revision in nearly two decades — IED’s central feature is impulsive aggression grossly out of proportion to the situation. People lose control, break or smash things and attack or threaten to hurt someone.

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The study, published this week in the journal of Archives of General Psychiatry, is being described as the first to estimate the prevalence of IED in U.S. adolescents. The researchers believe their findings could be extrapolated to Canada.

“If we can detect IED early and intervene with effective treatment right away, we can prevent a substantial amount of future violence perpetration and associated psychopathology,” said senior author Ronald Kessler, professor of health care policy at Harvard.

But Christopher Lane, author of Shyness: How Normal Behaviour Became a Sickness, said IED has been a source of controversy since it was formally approved as a mental disorder in 1980.

But equally concerning, he said, is the risk of “medicalizing” adolescence itself.

Disorders are defined by a list of diagnostic criteria. A person can qualify for a certain diagnosis based on how many criteria they meet for that illness. But there isn’t agreement on just how many “episodes” or outbursts of aggression are necessary for a diagnosis of IED.

The study is based on a national survey conducted in the U.S. between February 2001 and January 2004.

Dr. Allen Frances, former chairman of the psychiatry department at Duke University’s School of Medicine, chaired the task force that wrote the current edition of the Diagnostic and Statistical Manual of Mental Disorders. He called IED an “unstudied” and “inherently unreliable category that probably shouldn’t be in the DSM at all.”

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